Enterprise clinical information technology seems to have hit a similar flat spot. The major commercial IT platforms for hospitals and health systems are more than a decade old. Some of the older platforms are written in antique computer languages like COBOL and MUMPS, which predate the Internet by 20 years. Despite a societal investment of more than $100 billion, these tools have yet to demonstrate that they can reduce the cost or improve the efficiency of patient care. They remain cumbersome, expensive to install, maintain and operate. The user interfaces feel a lot like Windows 95 in an iPhone era.Yikes! Is it really that bad.......there are probably plenty of clinicians, patients and even some IT vendors who might accept that in some cases it is bad - I bet many of you can still find a text based system using some form of terminal emulation still in use somewhere in your clinical facility. In fact asking anyone to use systems with these kind of interfaces would seem wrong and such systems should either be pushed out into the digital graveyard where they belong or at a pinch shield the user from these idiosyncratic requirements and counter intuitive user interfaces.
But there are innovations and new use of technology - :in the piece "E-health and Web 2.0: The doctor will tweet you now; Patients can now meet their doctors in 'the cloud'" we can see the adoption of this technology to providing a rapid response more suited to the new age of instant communication and busy lives we lead today. It might be hard for a physician in the 1950's to understand the need for this speed of communication but bear in mind the treatment choices in those days were limited. In fact the father of a friend of mine at school was a physician and he described to me his experience of a "crash call" or "code blue"
If a patient had a problem the nurses would summon the porter who would be dispatched to my room to wake me up. I would be woken by a knock on the door and informed there was a patient "going off" on Ward xxx. I would get up, get dressed, more often than not the porter would leave a cup of tea outside my door and I would take that and then leave for the ward. By the time I arrived one of two things had happened. The patient had either died or had improved of their own accord. Their syncope, myocardial infarction or whatever event that had taken place was either resolved or resolving or they had succumbed to that critical event. There was little we could do or offer in the early days and rushing to the ward made no sense
Today we live in a technology and information rich society where instant communication is expected and can and does make the difference. In fact:
Jeff Livingston, an obstetrician and gynecologist in Irving, Texas, said his 10-doctor practice has about 600 Facebook fans and more than 1,500 Twitter followers
That's no small following and I am betting many social networking gurus and experts can only look at those numbers with envy. We don't fully understand how this technology and communications systems will impact healthcare and the delivery system but one thing is for sure rapid innovation and change will be the status quo.